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Mechanism of Formation of Human Calcium Oxalate Renal Stones on Randall's Plaque
Author(s) -
Evan Andrew P.,
Coe Fredric L.,
Lingeman James E.,
Shao Youzhi,
Sommer Andre J.,
Bledsoe Sharon B.,
Anderson Jennifer C.,
Worcester Elaine M.
Publication year - 2007
Publication title -
the anatomical record: advances in integrative anatomy and evolutionary biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.678
H-Index - 62
eISSN - 1932-8494
pISSN - 1932-8486
DOI - 10.1002/ar.20580
Subject(s) - calcium oxalate , apatite , chemistry , biomineralization , fourier transform infrared spectroscopy , calcium , oxalate , transmission electron microscopy , mineralogy , materials science , anatomy , biophysics , chemical engineering , biology , nanotechnology , inorganic chemistry , astrobiology , organic chemistry , engineering
Although calcium oxalate (CaOx) renal stones are known to grow attached to renal papillae, and specifically to regions of papillae that contain Randall's plaque (interstitial apatite deposits), the mechanisms of stone overgrowth on plaque are not known. To investigate the problem, we have obtained biopsy specimens from two stone patients that included an attached stone along with its tissue base and have studied the ultrastructural features of the attachment point using light and transmission electron microscopy, Fourier transform infrared spectroscopy (μ‐FTIR), and immunohistochemical analysis. The epithelium is disrupted at the attachment site. The denuded plaque that borders on the urinary space attracts an envelope of ribbon‐like laminates of crystal and organic matrix arising from urine ions and molecules. Into the matrix of this ribbon grow amorphous apatite crystals that merge with and give way to the usual small apatite crystals imbedded in stone matrix; eventually CaOx crystals admix with apatite and become the predominant solid phase. Over time, urine calcium and oxalate ions gradually overgrow on the large crystals forming the attached stone. Anat Rec, 290:1315‐1323, 2007. © 2007 Wiley‐Liss, Inc.